Are Probiotics Bad For You?

Written by Dr. Steve Chaney on . Posted in Probiotics

Are Probiotics Worthless?

Author: Dr. Stephen Chaney

 

are probiotics bad for youProbiotics (friendly gut bacteria) are all the rage. There is big money to be made, so the internet is ablaze with all the amazing things probiotics can do for you. Of course, most of those articles are posted by companies wanting to sell you their miracle mixture of probiotic bacteria.

In the last few weeks, you may have seen headlines proclaiming that probiotics are worthless. You just poop them out. Even worse, they may be upsetting the natural balance of bacteria in your gut. Are probiotics bad for you?  They may be.

As usual, the truth is somewhere in the middle. Before I start sorting out fact from fiction, let me remind you of some important facts about gut bacteria that I covered in a recent article of “Health Tips From The Professor”:

  • The composition of bacteria in our gut is influenced by what we eat. For example, meat eaters have a completely different composition of gut bacteria than vegetarians.
  • Fiber from whole plant foods is a major food source for healthy gut bacteria.
  • Each plant-based food group and each food within that group has a unique blend of fibers. We should probably aim for a wide variety of whole plant foods in our diet.

Are Probiotics Worthless?

 

are probiotics bad for you studyLet’s start with the study (N. Zmora et al, Cell 174, 1388-1405, 2018 ) that generated the headlines proclaiming that probiotics were worthless.

The characteristics of the study with my comments are as follows:

  • The study had 15 subjects who were given either a commercially available probiotic supplement or a placebo containing cellulose. It was a very small study.
  • The probiotic supplement contained 25 billion colony forming units of 11 commonly used strains of bacteria. Its manufacturer claimed the bacteria survived stomach acid and colonized the intestine, but no references were given for published clinical studies backing up that claim. It is buyer beware in the supplement industry. I would not believe any claims about a probiotic supplement that were not backed up by published clinical studies.
  • The investigators measured bacterial colonization of the mucosal cells lining the intestine rather than the population of bacteria that ended up in the feces. This is the “gold standard” for measuring colonization of the intestine by probiotic bacteria. However, it requires a colonoscopy before the study started and a second colonoscopy 3 weeks later. As any of you who have had a colonoscopy can attest, this is a very invasive procedure. It probably accounts for the small size of the study. In fact, the study started with 28 subjects and 13 dropped out, one after suffering a serious adverse reaction to the first colonoscopy. My point is simply that I don’t expect to see a lot of this type of study.

are probiotics bad for you supplementsThe results of the study with my comments are as follows:

  • Overall, the particular probiotic supplement used in this study didn’t work very well. There was minimal colonization of the intestinal mucosal cells by the bacteria in the probiotic supplement. Some did better than others, but the net colonization was small. We don’t know whether the results would have been the same with other probiotic supplements, but this is the finding that generated all the headlines. However, it is the rest of the study that is interesting.
  • The probiotic supplement worked better for some subjects than for others. Some of the subjects in the study were “permissive.” The probiotic cells colonized their intestinal mucosal cells with high efficiency. Other subjects were “resistant.”  Probiotic bacteria had a great deal of difficulty colonizing their intestinal mucosal cells. This doesn’t surprise me. Most clinical studies report an average result. They don’t report individual variations. This is one of the first studies to report on individual variation of probiotic colonization. As such, it has important implications. It means that even though you may be taking a probiotic supplement that has been “clinically proven” to survive stomach acid and colonize the intestine, it may not work well for you. But, wait, the study gets even more interesting.
  • How well the probiotic supplement worked depended on the population of bacteria in the intestine to begin with. “Permissive” and “resistant” subjects had very different species of bacteria in their intestine at the beginning of the trial. There was a characteristic grouping of bacteria in “permissive” subjects and a different characteristic grouping of bacteria in “resistant” subjects. This is the part of the study that should have generated headlines. Let’s put this part of the study into perspective.

We each have around 38 trillion bacteria in our intestines. Let’s assume that all 25 billion bacteria in the probiotic supplement make it into the intestine intact. You have just dropped them into hostile territory where they are outnumbered 1,000 to 1. We know that some bacteria secret substances that support the growth of “like-minded” bacteria. That’s why certain species of bacteria tend to cluster together. We also know that bacteria secret toxins, so they can out-compete bacteria they don’t like. So, it is no wonder the survival of the probiotic bacteria depends on which species of bacteria are already populating the intestine when they arrive on the scene.

This study leaves a lot of unanswered questions:

  • What determined the original population of gut bacteria? Was it the genetics or health of the subject? Or, was it the food they were eating? We simply don’t know.
  • We were sending these probiotic bacteria into hostile territory. Were we giving them the food they needed to survive? Would the results have been different for the “resistant” subjects if they had been eating a different kind of fiber-rich foods, or taken a prebiotic supplement? Again, we just don’t know.

If we want to optimize the results of probiotic supplementation, these are the questions we should be asking.

 

Are Probiotics Bad For You?

are probiotics bad for you thumbs downNow, let’s turn to the study (J. Suez et al, Cell 174, 1406-1423, 2018) generating the headlines saying that probiotic supplements may be bad for you. This study was looking specifically at the use of probiotics following antibiotic use.

The study reported when probiotics are used following antibiotic use, they delay, rather than enhance, the recovery of intestinal bacteria back to the same number and type of bacteria that existed prior antibiotic use. That’s the finding that generated all the headlines. Let’s put that into perspective.

Both the headlines and interpretation of the data were inaccurate.

  • Probiotics actually had a relatively small effect on the ability to regain your “normal” population of intestinal bacteria. The headlines made it sound as if the delay was significant and that you never regained your “normal” population of intestinal bacteria. In fact by one measure, the population of intestinal bacteria was 70% normal by 5 days, 80% normal by 20 days, and 95% normal by 90 days.
  • Poop pills work better but will probably never be popular. When the investigators extracted intestinal bacteria from the subject’s poop and put them into pills prior to the study, the poop pills restored the “normal” population of intestinal bacteria much more quickly. However, I doubt that poop pills will become popular any time soon.
  • Your “normal” population of intestinal bacteria may not be the optimal population of intestinal bacteria. The headlines implied that the fact you never recovered your “normal” population of intestinal bacteria was a bad thing. That assertion assumes that all of us have the optimal population of intestinal bacteria to begin with, an assertion that almost any expert in the field would find absurd. The last time I checked, one of the major reasons for taking probiotic supplements was to change our population of intestinal bacteria for the better.

The study ignores the major reasons for taking a probiotic supplement after antibiotic use. Most people are not taking the probiotic supplement to restore their original population of intestinal bacteria. They are taking it to:

  • Prevent “bad guys” like yeast from filling the void caused by the antibiotics.
  • Improve digestion. Some strains of intestinal bacteria play an important role in digestion. Because antibiotics wipe out those bacteria, they often cause gas, diarrhea, and bloating. After antibiotic use, people are taking probiotic bacteria with digestive benefits to eliminate those digestive issues as quickly as possible.
  • Strengthen the immune system. People are generally taking antibiotics to fight some sort of infection. Some strains of intestinal bacteria play an important role in immunity. Because antibiotics wipe out those bacteria, they weaken the immune system. After antibiotic use, people are taking probiotics to strengthen the immune system as quickly as possible

In short, taking probiotic supplements that are proven to improve digestion and strengthen the immune system play an important role in minimizing the side effects of antibiotic use.

What Does This Mean For You?

are probiotics bad for you truthAt the beginning of this article I said; “The truth lies somewhere in between.” The first study is a perfect example.

  • It was valuable in that it challenged the assertion by some manufacturers that their probiotics survive stomach acid and work equally well for everyone. At the very least, it suggests that we should demand clinical proof that any probiotic supplement colonizes the intestine and provides a health benefit before we use it.
  • The most interesting finding from the first study is that probiotics work much better for some people than for others, and how well they work depends on the population of bacteria in our gut prior to taking the antibiotic. We have much more to learn about this individual variability, and how to control it.

Until we know more, my best advice is to eat a fiber-rich, primarily plant-based diet with as many different varieties of fruits, vegetables, whole grains, and legumes as possible. Providing a variety of fibers is important because at least some of them will likely support the growth of the bacteria in the probiotic supplement. Prebiotics may be of some help, but only if they have been shown to be effective for the particular strains of probiotic bacteria they are paired with.

The second study was much less enlightening. It reported that taking a probiotic after antibiotic use slowed the return to the original population of intestinal bacteria. My response to that is: “So what?”

  • The effect was minimal.
  • The purpose of probiotics is to improve on the population of intestinal bacteria, not to return to the same population of bacteria you had prior to antibiotic use.
  • Probiotics are taken after antibiotic use for reasons that have nothing to do with restoring the original population of intestinal bacteria.

 

The Bottom Line

 

Two recent studies have challenged the benefits of probiotic use.

The first study provided some valuable insights.

  • It reported that a particular probiotic supplement did a very poor job of colonizing the intestine. We have no idea whether that would apply to other probiotic supplements, but that was the result that generated all the headlines. At the very least, it suggests that we should demand clinical proof that any probiotic supplement colonizes the intestine and provides a health benefit before we use it.
  • However, the most interesting finding from the first study is that probiotics work much better for some people than for others, and how well they work depends on the population of bacteria in our gut prior to taking the antibiotic. We have much more to learn about this individual variability, and how to control it.

The second study was much less enlightening. It reported that taking a probiotic after antibiotic use slowed the return to the “normal” population of intestinal bacteria that were present before antibiotic use. My response to that is: “So what?”

  • The purpose of probiotics is to improve on the population of intestinal bacteria, not to return to the same population of intestinal bacteria you had prior to taking an antibiotic.
  • Probiotics are taken after antibiotic use for reasons that have nothing to do with restoring the original population of intestinal bacteria.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

Groin Pain Relief

Posted April 16, 2019 by Dr. Steve Chaney

What Is The Pectineus Muscle And Why Is It Important?

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

 

Spring Is In The Air

spring floridaI remember as a child we sang “Though April showers may come your way…they bring the flowers that bloom in May…”

Of course, here in Florida we are blessed with flowers all year, but there’s still a lovely feeling that happens in Spring.  It’s still cool enough most days to go out running, and the humidity is still low.  Traffic will soon be easing up as our friends from the north start their trek back home, and daylight savings time is giving us more time to get to the beach for sunset.  Lovely!

Fun Facts About Spring….

  • The earliest known use of the term “spring cleaning” was in 1857
  • The word “spring” has been used for the season since the 16th century
  • The first day of spring is called the vernal equinox
  • On the first day of spring, the sunrise and sunset are about 12 hours apart everywhere on earth
  • Spring fever isn’t just a saying. Experts say the body changes due to the temperature and can cause an upset in your health.
  • The actual start of spring varies from March 19th to the 21st, but it is commonly celebrated on the 21st.

Do you like to garden?  Now is the perfect time to get your gardens planted so you’ll have home grown veggies for the entire summer.  For me, it’s also a great time to do some spring cleaning and get the house in order before the summer closes all the windows and the air conditioning becomes our indoor relief.

But these activities can also cause a strain on muscles, so don’t forget to take care of yourself. If you put too much strain on muscles you haven’t used all winter, you can develop problems and need groin pain relief.

 

A Tiny Muscle Can Cause Groin Pain

groin pain relief pectineusLately I’ve had several clients come in because of groin pain that has their medical practitioners stumped.  Their symptoms are varied, but most complain that it feels like they hit their pubic bone with a rubber mallet.  Ouch!

One client loves to ride her horse, but the pain had prevented that for several weeks. Another was considering selling the motorcycle that she and her husband love because she just can’t sit on it anymore.

Several years ago, I had a male client tell me that he had this same pain and he was told it could be his prostrate causing the issue.  Fortunately, that wasn’t he problem at all.

The muscle that caused all these problems, and a lot more, is the Pectineus.

The Pectineus muscle originates on your pubic bone and inserts into the very top of your inner thigh bone (femur).

You can see the Pectineus and surrounding muscles more clearly by going to https://en.wikipedia.org/wiki/Pectineus_muscle

Most muscles have more than one function, and this is true for the Pectineus.  The function we’ll look at today is called adduction.  It brings your leg in toward midline.  If you think of a soccer player kicking the ball with the inside of his ankle, it was the Pectineus that helped draw his leg in so he could do the shot.

Each of my clients had pain while trying to bring their leg out so they could sit on their horse, or on their motorcycle.  The tight muscle was pulling on their pubic bone and causing a severe strain.

This muscle is easier to have someone else treat it for you because of its location but give it a try and see if you can locate & treat it yourself.

 

Groin Pain Relief

groin pain relief treatmentThe picture to the left is showing an athlete self-treating her adductors.  These muscles, and the Pectineus muscle, all originate at the same point on the pubic bone.  The picture is showing her massaging the middle of the adductors.

To reach the Pectineus, move the ball all the way up to the crease in your leg.  You can do the treatment with a ball, but because of the size of the muscle and its location, it’s easier to do it with your fingertips.

Sit as this athlete is sitting, and even bring your opposite leg up so your foot is flat on the floor.  For example, in this picture, the athlete would bring her right leg up so her right foot is on the floor, and then lean a bit further onto her left hip.  That opens up the area so she can reach a bit easier into the muscle while using her fingertips.

Press into the muscle, being careful to feel for a pulse, and moving if you feel one.  If the Pectineus is in spasm, you’ll know it immediately when you press on it.  If it’s not in spasm, you won’t be able to find it at all.

Remember to stay within your pain tolerance level, this isn’t a “no pain, no gain” situation.  Never go deeper than what feels tender, but not so much that you want to faint. Hold the pressure for 15 seconds. Then let up on the pressure, but keep your fingers in the same place.

Repeat this movement several times. Each time it will hurt less, and eventually it won’t hurt at all.  That’s when the muscle has completely released, and you will have relief from the pain.

It’s as simple as that!

Why stay in pain when it’s so easy to find the muscular source of the problem and eliminate it?

calf cramps remedy bookTreat Yourself to Pain-Free Living (https://julstromethod.com/product/treat-yourself-to-pain-free-living-hardcopy/). It is filled with over 100 pictures and descriptions proven to show you how to find and self-treat muscle spasms from head to foot!

Join the 1000’s of people worldwide who have discovered that tight muscles were the true source of pains they thought were from arthritis, fibromyalgia, and other serious conditions.  You have nothing to lose, and everything to gain by releasing tight muscles.

Treat Yourself to Pain-Free Living is your step-by-step guide to pain relief!

 

Wishing you well,

 

Julie Donnelly

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

julie donnellyAbout The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

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